In patients with IPD who are detected to have hyperhomocysteinemia, the assessment of the cognitive performance, folic acid and vitamin B12 levels and the supplementation of folic acid and vitamin B12 to the treatment regimen might be appropriate.

No abstract

No abstract

No abstract

Geographical variation in the frequency of various gastroduodenal pathologies was shown to be related to the geographical diversity of H. pylori CagA Glu-Pro-Ile-Tyr-Ala (EPIYA) patterns. We examined the EPIYA patterns of H. pylori and the association of EPIYA patterns with gastric cancer (GC) for the first time, to the best of our knowledge, in Turkey. The patient group (PG) contained 60 patients [38 GC and 22 duodenal ulcer (DU) patients]. The control group (CG) was 110 individuals [94 gastritis patients and 16 persons with a normal gastrointestinal system (NGIS)]. Specific primers were used for the detection of cagA including empty-site-positive and EPIYA-A, -B, -C, -D PCR. Bands of EPIYA-A, -B, -C were confirmed by DNA sequencing. One hundred and forty-two (83.5 %) strains [60 in the PG (38 GC, 22 DU), 82 in the CG (72 gastritis, 10 NGIS)] were positive for the cagA gene. EPIYA-C with multiple repeats was detected in 34 (23.9 %) strains, and 22 (64.7 %) were from GC patients. EPIYA-C with one repeat was detected in 89 (62.7 %) strains, and 54 (60.7 %) were from gastritis patients. EPIYT was detected in 10 strains, and EPIYA-D was not detected. The number of EPIYA-C with multiple repeats was significantly higher for the PG than for the CG (P,0.0001). In GC patients, the number of EPIYA-C with multiple repeats was significantly higher than one repeat (P,0.0001). In conclusion, our study showed that multiple EPIYA-C repeats increases the GC risk by 30.6-fold and the DU risk by 8.9-fold versus the CG. This indicates that Western-type H. pylori strains in Turkey have similar EPIYA motifs to those of neighbouring countries and Western populations. INTRODUCTIONHelicobacter pylori is the principal cause of gastritis and gastric or duodenal ulcer (DU) diseases and is involved in the development of gastric cancer (GC) and mucosaassociated lymphoid tissue lymphoma (Atherton, 2006).H. pylori is a class 1 carcinogen identified by the International Agency for Research on Cancer for chronic and persistent infections. It is resistant to antibacterial agents in spite of innate and adaptive immunity (International Agency for Research on Cancer, 1994). Depending on virulence factors such as cytotoxin-associated gene A (CagA), blood group antigen-binding adhesion (BabA2) and vacuolating cytotoxin gene A (VacA), different genotypes cause different pathological and clinical outcomes and geographical regional differences (Atherton et al., 1995;Basso et al., 2008). Recently, the Glu-Pro-Ile-Tyr-Ala (EPIYA)Abbreviations: cagPAI, cag pathogenicity island; CG, control group; CI, confidence interval; DU, duodenal ulcer; EPIYA, Glu-Pro-Ile-Tyr-Ala; CagA, cytotoxin-associated gene A; GC, gastric cancer; NGIS, normal gastrointestinal system; PG, patient group; OR, odds ratio. pattern of CagA was suggested to be involved in the pathogenesis of GC, as this pattern manifests important variations depending on the region (Argent et al., 2004(Argent et al., , 2005.The CagA protein is injected into host epithelial cells with its peptidoglycan b...